Study of Relationship between Adrenal Insufficiency and Liver Cirrhosis
Abdelmaksoud, M., Soliman, A., Mohamed, E., Mahmoud, H., Badawy, A. (2025). Study of Relationship between Adrenal Insufficiency and Liver Cirrhosis. EKB Journal Management System, (), -. doi: 10.21608/zumj.2025.409397.4084
Mona Ahmed Abdelmaksoud; Amira Mohamad Soliman; Esraa Khaled Zaki Mohamed; Huda Elsayed Mahmoud; Ahmed Abo Elkhair Badawy. "Study of Relationship between Adrenal Insufficiency and Liver Cirrhosis". EKB Journal Management System, , , 2025, -. doi: 10.21608/zumj.2025.409397.4084
Abdelmaksoud, M., Soliman, A., Mohamed, E., Mahmoud, H., Badawy, A. (2025). 'Study of Relationship between Adrenal Insufficiency and Liver Cirrhosis', EKB Journal Management System, (), pp. -. doi: 10.21608/zumj.2025.409397.4084
Abdelmaksoud, M., Soliman, A., Mohamed, E., Mahmoud, H., Badawy, A. Study of Relationship between Adrenal Insufficiency and Liver Cirrhosis. EKB Journal Management System, 2025; (): -. doi: 10.21608/zumj.2025.409397.4084

Study of Relationship between Adrenal Insufficiency and Liver Cirrhosis

Zagazig University Medical Journal
Articles in Press, Accepted Manuscript, Available Online from 31 August 2025  XML
Document Type: Original Article
DOI: 10.21608/zumj.2025.409397.4084
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Authors
Mona Ahmed Abdelmaksoudorcid 1; Amira Mohamad Soliman2; Esraa Khaled Zaki Mohamed email 3; Huda Elsayed Mahmoudorcid 4; Ahmed Abo Elkhair Badawy5
1lecturer of Hepatology, Gastroenterology and Infectious diseases, Faculty of Medicine - Zagazig University
2Professor of Hepatology, Gastroenterology and Infectious diseases, Faculty of Medicine - Zagazig University
3Resident of Hepatology, Gastroenterology and Infectious diseases, Faculty of Medicine, Zagazig University
4Lecturer of Clinical Pathology, Faculty of Medicine - Zagazig University
5Lecturer of Hepatology, Gastroenterology and Infectious diseases, Faculty of Medicine - Zagazig University
Abstract
Background: Adrenal insufficiency (AI) is recognized as a potential complication among individuals with liver cirrhosis, though its true prevalence and clinical importance are still subjects of ongoing discussion.

Methods: We carried out this cross-sectional research on 60 adult patients with clinically and radiologically confirmed liver cirrhosis. They were classified into three equal groups based on Child-Pugh scores.

Results: AI was found among 20% of cirrhotic patients. The AI prevalence increased significantly across Child-Pugh classes A, B, and C (0%, 5%, 55%; p < 0.001). Patients with AI had higher Child scores (mean 10.17 vs. 6.97, p < 0.001), higher MELD scores (median 17 vs. 9, p < 0.001), lower serum albumin (mean 2.58 vs. 3.23 g/dL, p < 0.001), and higher INR (mean 1.35 vs. 1.17, p = 0.039) than those with normal adrenal function. AI was significantly correlated with lower total cholesterol, HDL, LDL, and triglyceride levels (all p < 0.05). Multivariate regression analysis identified the Child score as the sole independent predictor for both morning (β = –1.56, p < 0.001) and evening cortisol levels (β = –0.54, p = 0.014). Serum cortisol correlated positively with systolic blood pressure, albumin, calcium, and lipid profile (all p < 0.05), while negatively with pulse, hepatic encephalopathy, ascites, Child and MELD scores, INR, PT, PTT, total bilirubin, creatinine, and BUN (all p < 0.05).

Conclusion: Adrenal insufficiency was a common and under-recognized complication in cirrhotic patients, particularly in those with more advanced disease and impaired lipid profiles.
Keywords
Adrenal Insufficiency; Relationship; Liver Cirrhosis
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